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Researchers at the National Cancer Institute, whose study results showed that HPV tests more accurately reflect a woman's risk of developing cervical cancer than the Pap test, say their findings provide evidence to support the use of HPV and Pap tests together, and the possibility of using the HPV test as the primary screening test for cervical cancer.
(Associated Press)

A woman whose screening test for human papillomavirus, or HPV, comes back negative has an extremely low risk of developing cervical cancer - a much stronger indicator than a negative Pap test, according to the findings of a study published online July 18 in the Journal of the National Cancer Institute.

The findings were based on data of test results for more than 1 million women.

An estimated 12,360 new cases of invasive cervical cancer will be diagnosed in the United States in 2014, according to the American Cancer Society; an estimated 4,020 women with the disease will die from it this year..

The HPV test, designed for routine use in women over age 30, detects the presence of high-risk types of HPV in the cells of the cervix. The Pap test detects abnormal cell changes from the cervix that are associated with the development of cervical cancer.

In 2012 the U.S. Preventive Services Task Force issued new guidelines calling for women ages 30 to 65 to get a Pap test every three years, but said it preferred that women whose Pap test results come back normal get that test - along with the HPV test - every five years instead.

NCI researchers and their colleagues published findings the previous year, in 2011, on screening outcomes for about 300,000 of women ages 30 to 64 in California who had co-testing (the HPV test and Pap test given at the same time). All of the women had health coverage from Kaiser Permanente Northern California, which has conducted the co-testing since 2003.

In the new study, the researchers broadened their analysis to include more than 1 million women who were screened through December 2012. They estimated cervical cancer risks among women who tested HPV-negative alone, Pap-negative alone, and cotest-negative.

The researchers then compared risk estimates based on guidelines issued in 2012 by the U.S. Preventive Services Task Force calling for Pap testing every three years and co-testing with the HPV test every five years in women ages 30 to 65.

What they found: The risk of developing cervical cancer within three years following a negative HPV test result was about half of the already low risk following a negative Pap test; and was similar to the risk of developing cancer within five years following a negative co-test.

Based on their findings, the researchers estimated that 20 per 100,000 women with a negative Pap test would develop cervical cancer over three years.

For women with a negative HPV test, the number was 11 per 100,000 women; 14 per 100,000 women whose co-test came back negative would develop cervical cancer over five years.

"We find that primary HPV testing every three years might provide as much,

if not more, reassurance against pre-cancer and cancer, compared to primary Paptesting every 3 years and co-testing every five years," they wrote, adding that further analysis needs to be conducted to identify the optimal screening interval and preferred screening strategy.

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